Modified dental implant fixture

ABSTRACT

A modified dental implant fixture designed to preserve lingual bone by having the coronal aspect of the implant being compatible with bony anatomy that is higher on the lingual side of the implant surgical site. The implant may be of either the single stage or the two stage design. By modifying the shape of the top of the implant fixture to mimic healing/healed bony anatomy, bone is preserved and bone growth is possibly encourage.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. application Ser. No.10/223,773, filed Aug. 19, 2002, now U.S. Pat. No. 6,672,872, which is acontinuation-in-part, and, therefore, claims benefit under 35 U.S.C.§120, of U.S. patent application Ser. No. 10/011,866 filed Dec. 3, 2001now U.S. Pat. No. 6,655,961.

BACKGROUND OF THE INVENTION

The present invention relates generally to dental implants, and morespecifically to a dental implant having an improved configuration totake advantage of the bone topography that is often present followingtooth extraction.

Dental implants are used in place of missing and/or extracted naturalteeth as the base of support for an abutment and final prosthesis in theattempt to restore normal oral function. Once teeth have been extracted,the alveolar bone at the extraction site heals and begins to undergoresorption. The resorption process is halted by restoring loading forceswith a dental implant. The topographic changes of the alveolar bone havebeen described in the dental literature and are time dependent withregard to the amount of bone resorption. While implants are designed toreplace natural teeth, they must also be designed to consider thephenomenon of how bone heals and remodels following tooth extraction.

The implant body is surgically inserted in the patients jaw and becomesintegrated with the bone. More specifically, the implant body is screwedor pressed into holes drilled in the respective bone. The surface of theimplant body is characterized by macroscopic and microscopic featuresthat aid in the process of osseointegration. Once the implant is fullyintegrated with the jaw bone, the abutment is ready to be mounted. Fortwo-stage implant designs, the abutment passes through the soft tissuethat covers the coronal end of the implant after healing and acts as themounting feature for the prosthetic device to be used to restore oralfunction. Implants of the single-stage design extend through the tissueat the time of surgical insertion. The coronal end of the implant bodyacts as part of a built-in abutment design with the margin of thecoronal collar usually used as the margin for the attachment of theprosthesis used to restore oral function. These components, the implantand abutment, are typically fabricated from titanium or an alloy oftitanium as well as zirconia based, alumina based or sapphire basedceramics. In some instances, ceramics and metals are combined to make asingle component, though this is usually limited to the abutmentcomponent of the implant system.

One of the major problems associated with dental implants stems from thefailure to provide for the ideal alignment of implant fixtures in bone.Misalignment often results in the implant being positioned lingual tothe ideal placement. Loosening or fracture of the abutments and even theimplant body can result due to the adverse forces involved. Restorativedentists complain that the implants are not properly aligned by thesurgeons, and the surgeons complain that the restorative dentists do notunderstand the challenges associated with the alignment process.

One of the most commonly placed fixture designs is the Branemark typeimplant. These implants are ideally positioned in the approximate centerline of the space where the extracted tooth was previously positioned.As with most traditionally designed implants, the Branemark type fixturerelies on a flat surface perpendicular to the long axis of the implantbody for strength when joining the implant and the abutment together.This design usually displays a bone loss pattern described as a cuppingof the bone at the coronal end of the implant once loaded with occlusalforces. This cupping pattern usually stabilizes after about one year offunction with vertical bone loss of approximately 2 mm but, by thattime, loss of bone critical to the predictable support of overlying softtissue is lost.

Other implant systems often used are of the so called Astra Tech and ITIStraumann type implants. These implant designs have an internal conicalconnector and do not rely on perpendicular orientation of a flat surfacefor strength at the implant/abutment interface. Astra implants, due toor in combination with the rigid conical abutment connection and thepresence of coronal stress reducing micro threads on the implant body,greatly reduce, and in some instances do not display the aforementionedbone loss patterns. However, the problem still exists as to themisalignment of such implants due to the flat topped coronal feature ofthe implant body in its present configuration.

Astra Tech has addressed coronal bone loss by introducing micro threadsat the coronal portion of the implant body to distribute forcestransferred to the surrounding bone. Other attempts to enhance implantdesigns have addressed bone loss patterns and lack of soft tissuesupport by focusing on the coronal aspect of the implant body in hopesof mimicking natural CEJ (cemento-enamel junction) anatomy or shapingthe implant body to be more root like in character. Implants duplicatingtooth anatomy in some way, shape or form have not had the same level ofsuccess as the Astra Tech concept. Unfortunately, once the tooth hasbeen extracted, the bone does not remember what the tooth looked like,or what function it provided. Implants must be designed as dentalimplants, not morphic copies of teeth. Even with the Astra's success,the design of the implant fixture and how that design interacts with thebony anatomy at the surgical site has not been addressed correctly. Todate, no design has considered the anatomy of how bone heals in thehuman jaw following tooth extraction.

Accordingly, it is a general object of the present invention to providean improved implant such that many of the problems related to implantplacement are eliminated.

It is another general object of the present invention to incorporatedesign features that take advantage of how bone heals.

It is a more specific object of the present invention to enable implantsto be placed in surgical sites of sloping bony anatomy more preciselyand predictably.

Another object of the present invention is to preserve lingual bone byhaving the coronal aspect of the implant being compatible with the bonyanatomy that is higher on the lingual side of the surgical site.

It is another object of the present invention to provide for increasedstrength of the implant/abutment system.

Yet another object of the present invention is to reduce the amount oftime required by the restorative dentist to prepare and idealize theabutment.

Another object of the present invention is to reduce the number ofabutment orientation surfaces, thereby reducing the size requirement forthe implant body.

Still another object of the present invention is to make the use of snapon impression caps more useful and resulting in the final prosthesisbeing more functional and cosmetic in appearance.

Yet another object of the present invention is to allow for a singleimplant to be placed in the anterior region of the human jaw withpredictable soft tissue contours supported by bone.

Still another object of the present invention is to allow multipleimplants to be placed more predictably next to one another in theanterior region of the human jaw.

Another object of the present invention is to combine the two-stageimplant design having a length greatest on the lingual side of the jawwith an internal conical connection.

Still another object of the present invention is to modify the design ofsingle stage implants to have features that enhance placement in slopingbony anatomy.

These and other objects, features and advantages of the presentinvention will be clearly understood through a consideration of thefollowing detailed description.

SUMMARY OF THE INVENTION

According to the present invention, there is provided a dental implantfor implanting within a human jawbone, the jawbone having lingual andbuccal sides. The implant includes a generally cylindrical longitudinalbody with an outer surface, an apical end and a coronal end. An abutmenthaving a lower portion for connecting with the body. The coronal end iscontoured such that when the implant is positioned within the jawbonethe length between ends of the body is greatest within the lingual thirdof the jawbone.

BRIEF DESCRIPTION OF THE DRAWINGS

The features of the present invention, which are believed to be novel,are set forth with particularity in the appended claims. The invention,together with the further objects and advantages thereof, may best beunderstood by reference to the following descriptions take inconjunction with the accompanying drawings, in the several figures ofwhich like reference numerals identify like elements, and in which:

FIG. 1 is a side view of the ideal implant placement within the jawbone.

FIG. 2 is a side view of the ideal alignment of a typical implant buriedwithin the jaw bone with sloping topographic anatomy to avoid fixturethread exposure.

FIG. 3 is a front view of a Branemark type implant design showingtypical cupping bone loss at the coronal aspect of the implant afterloading with functional forces.

FIG. 4 is a side view of the ideal alignment of a typical implant withinthe jaw bone with sloping topographic anatomy having threads exposed onthe facial aspect of the implant body.

FIG. 5 is a side view of the typical implant placed within the center ofthe maximum available bone height.

FIG. 6 is a side view of the preferred embodiment of the implant of thepresent invention.

FIG. 7 is an elevated side view of another embodiment of the implant ofthe present invention with a small sized contoured abutment attachedcoronally.

FIG. 8 is an elevated side view of another embodiment of the implant ofthe present invention with a large sized contoured abutment attachedcoronally.

FIG. 9 is an elevated front view of the preferred embodiment of theimplant of the present invention.

FIGS. 10-12 are elevated side views of similar embodiments of thepresent invention.

FIG. 13 is a side view of the preferred embodiment of the implant of thepresent invention of the two stage type design with an abutment designedto be used with snap-on impression caps.

FIG. 14 is a side view of the preferred embodiment of the implant of thepresent invention of the single stage type configured to be used withsnap-on impression caps.

FIG. 15 is a front view of a Branemark type implant and associatedabutment design.

FIG. 16 is a side view of an Astra type implant and preferred embodimentassociated abutment design.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Dental implants are used in place of missing and/or extracted naturalteeth as the base of support for an abutment and final prosthesis in theattempt to restore normal oral function. Once a tooth has beenextracted, the bone from which the tooth originated heals and is foreverchanged and probably continuously changing due to the forces exerted onit. Dental implants need to be designed to take into account the naturalhealing process of bone.

Referring now to the Figures, and in particular FIG. 1, a typicalimplant 10 is illustrated implanted within the jaw bone 12. For purposedof describing the invention, the bone 12 of the human jaw will primarilybe discussed with respect to its lingual 14 and buccal 16 sides. Thisbone 12 illustrated by FIG. 1 is that of an ideal, but infrequentimplant site. That is, lingual side 14 and buccal side 16 bone appear tobe comparable in height and shape with respect to the center 18 of themaximum height of available bone. Therefore, the typical implant 10,with its flat top or coronal aspect 20 is suitable for its intendedpurpose when implanted within such a jaw bone condition.

However, when teeth are extracted, this ideal bone site of FIG. 1 isseen more frequently in drawings from implant manufacturers rather thanat the actual surgical sites encountered during surgical placement ofimplant fixtures. This is because the bone does not heal evenly once atooth has been extracted. It has been found that bone heals based on theprinciples of bone biology and surrounding bony anatomy, surroundingbony and soft tissue anatomy as well as blood supply to the area. To adegree, bone healing and/or remodeling is influenced by the placementand subsequent loading of an implant fixture in the area of theextracted tooth or teeth. A number of studies have been conductedregarding bone loss patterns following tooth loss. One such outstandingstudy, by Cawood and Howell was published in the International Journalof Oral and Maxillofacial Surgery in 1991.

This study analyzed patterns of alveolar bone resorption from a sampleof 300 dried skulls with edentulous jaws. In general, bone loss is fourtimes greater in mandible than the maxilla. One can construe from thisstudy that the highest point of bone anatomy is at the lingual side ofextracted teeth after healing for a time period even as short as severalmonths. Due to the natural bony contours in the anterior area of theupper and lower jaws, this healing pattern, often referred to as facialcollapse of bone, is more immediate than in the posterior upper andlower jaws. If an implant fixture is placed in the center of the maximumheight of available bone, the implant can end up too far to the lingualfrom the point of view of the restorative dentist.

To avoid this overly lingual placement, implants can be submerged evento the facial level of bone. FIG. 2 is illustrative of such a submersionas the implant 22 is shown with its coronal aspect 20 fully submerged onthe lingual side 14 and even with the bone 12 on the buccal side 16. Thecrown 24 to be attached to the abutment is then affixed to the coronalaspect 20 in an attempt to restore normal oral function. As such animplant needs to be buried within the bone to compensate for the shapeof the healing bone, the implant 22 must be significantly shorter inlength than the ideal size shown in FIG. 1. This results in a weaker andless stable implant/abutment complex.

Another problem with burying implants is illustrated by FIG. 3. ThisFigure shows a typical Branemark type implant 26 which was previouslyburied within the bone 12 as discussed above. After the implant has beenaffixed with an abutment and crown, the loading forces typically producea bone loss pattern referred to as cupping 28. This bone loss usuallyexposes the threads 30, and, essentially, results in the placement ofwhat amounts to be a shorter implant and thus a weaker implant in thejaw bone.

Another way to avoid overly lingual implant placement is illustrated byFIG. 4. Here, the implant 10 has been inserted into the bone 12 with theproper alignment (as it had in FIG. 2), but now the implant isprotruding due to the sloping bony anatomy. Maximum height of availablebone was engaged, but exposed threads 32 compromise the ideal facialcontour of the final restoration.

While the positioning of the implant is improved by burying orprotruding same, supporting bone is compromised in one instance (FIG. 2)and poor gingival profile results within the other placement (FIG. 4).In an attempt to avoid these problems in the mandible, surgeons may optto misalign the implant by angling its position as shown in FIG. 5.Here, the implant is angled towards the lingual to avoid perforating thelingual plate of bone 34. In other words, the implant 10 is placed inthe middle of the highest point of bone 36 lingual to where the missingtooth was previously positioned. Thus, this kind of positioning maycreate the greatest problem for the restoring dentist as he now mustattempt to esthetically and functionally position the crown 24 andabutment.

Proper alignment of the dental implant is essential to the esthetics aswell as the mechanics of proper oral function. If the abutment and crownare affixed to a misaligned implant, the tooth not only looksunattractive, but it will not be able to function properly asunfavorable loading forces will exist. Referring back to FIGS. 1-5, FIG.1 shows a properly aligned implant 10 and thus and thus a properlyaligned crown 24. FIGS. 2 and 4 show proper alignment of the implant,but demonstrate other problems previously described. Finally, FIG. 5shows an improperly aligned implant and thus a crown affixed to thebuccal of the implant fixture.

Additionally, the type of abutment connection incorporated into theimplant design, i.e. the Branemark design of FIG. 3 or the Astra designof FIGS. 1-2 and 4-5, results in implants having decidedly differentclinical characteristics. In particular, and referring to FIG. 15, theconnection between the implant body 100 and the abutment 102 of atwo-stage implant of the Branemark design is characterized by a slipjoint connection, using an external hex 104 on the coronal end of theimplant in connection with the internal hex 106 of the abutment, andflat matting surfaces 108 between the abutment 102 and the implant 100which are perpendicular to the long axis of the implant. These flatsurfaces limit the joint connection as the parts come together. The slipfit joint typical of the Branemark and other flat matting platformdesigns result in a tipping action 110 causing loading stress patterns112 on one side and strain patterns 114 on the other side of the implantbody, because the outer edge 115 to the flat platform 108 acts as amechanical fulcrum point. It is hypothesized that when thisstress/strain on the coronal surface of the implant body is transferredto the surrounding bone, cupping (previously discussed) bone lossoccurs.

By contrast, the Astra-type implant uses what is referred to as aconical connection which is characterized by the male 116 and female 118cones of FIG. 16. The typical taper 120 for the connection of thesecoronal extension components range, but are not limited to, from about 5to 30 degrees. The degree of taper is one factor that determines theextent the two components are swagged together when the connection boltis threaded through the bolt hole of the abutment 122 and the threadedhole of implant 124 and tightened. The swagged fit becomes a cold weldas far as the implant 126 and the abutment 128 connection are concerned.This eliminates micro movement and distributes the stress/strain farmore favorably at the coronal end of the implant body. The mattingsurfaces of this conical connection need no flat joint limiting surfacesperpendicular to the long axis of the implant body because the male andfemale mating surfaces and the joint limiting surfaces are one in thesame. Upon off axis loading forces this type of abutment-fixture jointdistributes stress 130 more evenly within the joint itself avoiding peakloading moments and resulting in a tight and bio-mechanically stableconnection.

Since the Astra Tech type implants do not have a flat coronal aspectthat is integral to the abutment connection, it is possible to shape thecoronal contours to mimic healing/healed bony anatomy at the implantsurgical site. Additionally, because Astra Tech implants do not loosecoronal bone as do the Branemark type implants, it is possible topreserve and possibly encourage slight bone growth in the coronaldirection. By preserving lingual bone height, bone mesial and distal tothe implant will also be maintained because, according to studies,including Cawood and Howell, bone slopes apically from the lingual.Preserve the lingual bone, and more bone adjacent to the implant on themesial and distal sides will be preserved. This is critical ifpredictable soft tissue papilla overlying these hard tissue sites is tobe generated or maintained. It has been shown that only 4 mm of papillaheight over mesial and distal bone is considered a level that therestorative dentist can rely on being generated time and again. Withoutsurrounding esthetic papilla, even the most perfectly contoured crown isunsightly in the upper anterior region of the mouth.

Accordingly, the present invention will be described as it relates tothe Astra type swagged implant. In particular, the combination of theconical connection and the incorporation of stress distributing microthreads/grooves in the coronal aspect of the implant in addition tosurface texturing seem to be the primary design factors preventing“cupping” bone loss from occurring. In its broadest aspects, the designmodification of the present invention comprises a revised angle of slope132 of both the implant and abutment. This revision extends to theabutment contour 134 as well. It will be appreciated that in order forthe sloped design modification to be of any value, the problem of“cupping” bone loss must be overcome. The implant design cannotsignificantly modify the bony topography/anatomy once the implant isloaded. Secondly, the basic design has to be such that it can in fact bemodified to incorporate alternate coronal contour to mimic how boneheals following tooth loss. Thus the basic design of the two stage Astraimplant allows not only for this modification, but for this modificationto be effective.

The preferred embodiment of the present invention is illustrated by FIG.6. The implant 40 is a cylindrical longitudinal structure designed forbone 42 engagement. The typical length 82 (FIG. 9) of the preferredembodiment is much like the currently used implants. That being between9 to 18 mm base 84 to top 86 (FIG. 1) while the typical diameter isbetween 3 to 6.5 mm base 84 to top 86. The body of the implant 40 ispreferably, but need not be, comprised of screw threads 46 to aid in theimplantation process. The lower (apical) portion 48 of the implant bodyincludes larger threads 46 a than the smaller threads 46 b of the upper(coronal) portion 50. It has been found that the smaller threads 46 bsignificantly reduce stress forces transmitted to bone and helps topreserve cortical bone. They also increase the fixture strength byadding wall thickness without changing the outer dimension of theimplant, compared to larger and deeper threads in the same area of theimplant. (These deep threads of current practices tend to dig into thebody of the implant and weaken it). However, other means may be used onthe outside surface of the implant 40 affixed to the implant within thebone 42, so long as the apical end 44 thereof is securely anchored. Thesurface of the implant 40 may be textured/coated in differing ways topromote osseointegration.

The coronal end 52 of the implant 40 accepts the base of the prostheticabutment 54 using connection mechanisms of different designs. An exampleof such a design is the hex shape 56 shown on the implant 26 of FIG. 3.While the commonly used internal hex or twelve position internal stardesign can be used, other options are now possible since the implantdesign has one vs. multiple orientations. Three to five sided abutmentalignment surfaces with from three to twelve internal designs arefeasible; even one or two alignment surfaces are possible. Reducing thenumber of abutment orientation surfaces reduces the size requirementsfor this feature of the implant body. This is important in developingsmaller fixtures suitable for use to replace lower anterior teeth.

The basic concept of the present invention is the contouring or slopingof the coronal 52 or top of the implant fixture such that lingual bone14 is engaged and preserved. This coronal contour can be a straight lineor a slightly convex contoured design so long as one bone engaging side56 of the implant body (which would become the lingually oriented sideof the implant fixture) is longer in the apical-coronal bone engagingdimension than any other apical-coronal bone engaging dimension. Thisapical-coronal dimension or lingual high point does not include anyimplant collar (if present), but only the bone engaging surface of theimplant since the invention primarily addresses bone preservation withpredictable soft tissue preservation being understood to be dependent onmaintaining underlying supporting bone. Biomechanics are improved forthe entire implant 40 abutment 54 and crown 24 complex. Soft tissues 58are much more predictable since underlying support bone is preserved.

Surgeons will be much less inclined to place fixtures at the middle ofthe maximum height of available bone which is often to the lingual ofthe desired implant position (see FIG. 5). The sloping surface of thecoronal 52 makes it much more likely that placement in the center of thespace formerly occupied by the missing tooth will be possible. Becausethe lingual aspect of the implant 40 can be placed more coronallywithout the compromise inherent with flat top designs (See FIGS. 2-5), amore favorable implant fixture to prosthesis ratio results whichimproves stress distribution. Furthermore, the design of the presentinvention does not reduce the strength of the implant, but in fact makesit stronger by extending the lingual side of the fixture coronally. Theimplant fixture, when surgically placed, is longer by the height of thelingual coronal extension, but is not placed deeper in the jaw bone.

Referring now to FIG. 7, the abutment 54 design simulates or followsnatural tissue contours 58 because of the coronal sloping 52 feature ofthe implant. This dramatically reduces the amount of time required bythe restorative dentist to prepare and idealize the abutments.Similarly, FIG. 8 shows a contoured abutment 60 of a larger size, whichmay be more suited for a molar tooth. In any event, the designs of FIGS.7 and 8, or any similar designs that have tissue or gingival contour totake advantage of the coronal contour of the implant body, will enablethe restorative dentist to idealize final margin placement rapidly.

The contouring or sloping of the coronal 52 or top of the implantfixture may best be illustrated by FIG. 9. Here, the differentialbone-engaging surface of the implant 40 is shown with respect to itsbuccal length (L₁) 80 in comparison to its lingual length (L₂) 82. Whilethe preferred contour may differ from patient to patient, preferably theheight differential (L₂−L₁) 88 is between 1 and 4 mm, more preferablythis differential 88 is between 2 and 3 mm. Therefore, as is shown, thebone-engaging surface, or the outer surface of the implant which is incontact with the jaw, of the implant 40 is longer on one side (lingual)than the other. With such a shape, bone preservation throughout the jawis achieved.

The coronal end 50 of the implant body 40 is preferably characterized bytextured grit blasting 62, (or acid etching, plasma spray technique,etc.) with or without micro threads/grooves 46 b as shown in FIG. 10. Ifmicro threads/grooves are evident, they may be perpendicular (FIG. 10)to the long axis 64 of the implant 40, or parallel to the sloped (FIG.11) or convex (FIG. 12) coronal contour 52. Having the microthreads/grooves 46 b parallel to the coronal contour 52 as in FIGS. 11and 12 may further aid in bone preservation and possibly coronal boneapposition.

FIG. 13, like FIGS. 6-12, illustrates a design of the present inventionas it relates to a two-stage type implant. The body 40 of the implant iswidest at the most coronal bone engaging aspect 66 and narrows movingapically before having parallel walls 68 in the apical half of thefixture. This inward coronal feature allows for thicker bone surroundingthe implant coronally, while at the same time creating adequate coronalwidth to resist mechanical occlusal loading. The two-stage design ofFIG. 13 takes advantage of the sloped coronal surface 52 and enables theuse of a snap-on impression caps. These impression caps engage theundercut 70 of the abutment margins.

FIG. 14, unlike FIGS. 6-12, illustrates a design of the presentinvention as it relates to a single stage type implant. This implant 72also incorporates the sloped coronal 74 contours of the aforementioneddesigns. All advantages that apply to the two stage implant design applyto this design as well. A machined collar 76 coronal to the microthreads 46 b and/or the textured surface 62 does not engage bone (thenon-bone engaging surface of the implant) and passes through the softtissue 78. This design allows for snap on impression caps (as describedabove) deemed essential to single stage designs. The perfect alignmentafforded to the implants of FIGS. 13 and 14, due to the sloping coronal52, provide for the perfect environment for snap-on impression caps.

Whether utilizing a single stage or a two-stage type implant, the basicmethodology for the surgeon remains the same. First, the implant site ischosen. Next, taking into account the chosen site, the physical designfor the shape and size for the implant is chosen. This is dependent uponthe remaining jawbone shape and size as well as other factors. Thisdesign will include overall length as well as coronal differential,among others. Now, the surgeon positions the implant within the bone.

The present invention provides for more latitude to the surgeon withrespect to placement of these implants. For example, single implantsplaced in the esthetic zone (upper anterior) will be much morepredictable in outcome since soft tissue supporting bone mesial anddistal of the implant body is preserved since bone on the lingual aspectof the fixture is not sacrificed or compromised. Similarly, the fixturedesign allows multiple implants to be placed in the esthetic zone,including implants placed next to one another. Since inter-implant boneis essentially preserved by the height of the lingual bone which is notsacrificed or compromised, papilla are maintained in the spaces betweenfinal implant supported restorations.

While a particular embodiment of the invention has been shown anddescribed, it will be obvious to those skilled in the art that changesand modifications may be made therein without departing from theinvention in its broader aspects, and, therefore, the aim in theappended claims is to cover all such changes and modifications as fallwithin the true spirit and scope of the invention.

1. A dental implant for implanting within a human jawbone, the implantcomprising: a longitudinal body having an outer surface, an apical endand a coronal end, a lingual side and a buccal side; wherein said bodyhas a length along said outer surface between said apical and coronalends, and wherein said coronal end is configured such that said lengthis greatest on the substantially lingual side and least on thesubstantially buccal side such that said length continuously decreasesfrom said lingual side to said buccal side.
 2. A dental implant of claim1, wherein said body is substantially circular.
 3. A dental implant ofclaim 1, further comprising a circumferentially oriented texture surfacenear said coronal end.
 4. A dental implant of claim 3, wherein saidcircumferentially oriented texture surface comprises circumferentialgrooves.
 5. A dental implant of claim 3, wherein said circumferentiallyoriented texture surface comprises micro-threads.
 6. A dental implant ofclaim 5, further comprising threads near said apical end.
 7. A dentalimplant of claim 6, wherein said threads are deeper than saidmicro-threads.
 8. A dental implant of claim 6, wherein said threads arelarger than said micro-threads.
 9. A dental implant of claim 5, whereinsaid micro-threads have multiple starting points.
 10. A dental implantof claim 5, wherein said micro-threads are bone engaging micro-threads.11. A dental implant of claim 1, wherein said coronal end has aconnection feature adapted to accept an abutment.
 12. A dental implantof claim 11, wherein said connection feature is a female cone.
 13. Adental implant of claim 1, wherein said body is widest at said coronalend and narrows to parallel surfaces at said apical end.